| Jacob D Kelly Dds, Inc. | |
|
2360 Professional Dr Ste 100 Roseville CA 95661-7782 | |
| (916) 782-9479 | |
| (916) 782-3342 |
| Full Name | Jacob D Kelly Dds, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2360 Professional Dr Ste 100, Roseville, California |
| Authorized Official Name and Position | Jacob Dean Kelly (OWNER DENTIST) |
| Authorized Official Contact | 9167829479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob D Kelly Dds, Inc. 2360 Professional Dr Ste 100 Roseville CA 95661-7782 Ph: (916) 782-9479 | Jacob D Kelly Dds, Inc. 2360 Professional Dr Ste 100 Roseville CA 95661-7782 Ph: (916) 782-9479 |
| NPI Number | 1447821319 |
|---|---|
| Provider Enumeration Date | 07/01/2021 |
| Last Update Date | 07/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447821319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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